Cataract surgery can help improve your vision. It removes the clouded lens and replaces it with an artificial lens to see properly. In normal cases, you have a clear lens to see properly. But, the cataract can cause clouding, which makes seeing through the lens like looking through a fogged-up or frosty window. Clouded or blurred vision caused by cataracts makes it difficult to read, see the expression on other’s faces or drive a car at night. A cataract develops slowly triggering little or no symptoms at first. But, it can develop and affect your lens as time progresses. So, it interferes with your vision. The ophthalmologist (eye specialist) performs it on an outpatient basis. The surgery to remove a cataract is a common and safe procedure. So, it opted by many people to make their vision clear and better. Read ahead to know more about it.
Symptoms Of Cataract
How can you detect you suffer from cataracts? Certain signs indicate the presence of the eye problem. So, pay close attention to the following:
- Sensitivity to glare and light
- Clouded, dim or blurred vision
- Trouble seeing properly at night
- Need for brighter light to read and perform other activities
- Seeing lights with halos
- Frequent changes in your eyeglass/contact lens prescription
- Double vision in one eye
- Yellowing or fading of colors
In the initial phases, the cloudiness in your vision caused due to cataract affects only a small part of the lens in your eye. So, you may not become aware of vision loss. But, as the cataract grows. The clouding in your vision increases as the cataract grows larger. So, you can notice more symptoms.
Causes Of Cataract
Cataract forms in your eye lens. The lens is positioned behind the iris (the colored part). In normal cases, your eye lens focuses light passing into the eye. So, it aids in producing clear and sharp images on the retina. Due to aging or other cases, your lens in the eyes becomes less transparent, flexible or thicker. The conditions can lead to the tissue within the lens to clump together, break down, cloud and lead to vision issues. Without proper management, cataract tends to develop further and clouding can increase. It becomes denser and covers your entire lens. The cataract tends to scatter and block the light passing through your lens. So, instead of a sharply defined image reaching the retina, you see blurred images. The risk factors triggering the condition are:
- Injury changes in the tissue that makes the lens of eyes
- Aging
- Inherited genetic disorder
- Medical conditions (like diabetes)
- Past eye condition
- Long term use of steroid medications
- Prior eye surgery
So, people who face the risk factor need to make an appointment with their eye doctor. Detecting the problem early makes it easier to manage it easily.
Diagnosing Cataracts
Before deciding on surgery, you need to see a doctor get a proper diagnosis. When you see a specialist doctor or ophthalmologist for your problem, the following methods can diagnose the problem:
Physical Assessment
To determine if you suffer from cataract, the doctor checks your symptoms as well as check your medical history. Then, the doctor performs an eye examination. To confirm the problem, the doctor also conducts other tests.
Visual Acuity Test
It is the test that uses a chart to measure your eyesight. Using the chart, an ophthalmologist can see how well you can read a series of letters. The eye doctor tests the eye separately. You need to cover one eye while reading with the other. The chart or viewing device has progressively smaller letters. Testing using it can determine if you show signs of impairment or have 20/20 vision.
Slit-lamp Examination
A microscope called a slit lamp allows the eye specialist to see structures at the front of your eye. Since the eyes are under magnified, your doctor can see areas like lens, cornea, iris, and the space between cornea as well as the iris. The slit lamp uses an intense line of light that allows the viewing of structures in small sections magnified. So, it is easier to detect any small or tiny abnormalities with ease.
Retinal Exam
To prepare for a retinal exam, your eye doctor puts drops in your eyes to open your pupils wide (dilate). This makes it easier to examine the back of your eyes (retina). Using a slit lamp or a special device called an ophthalmoscope, your eye doctor can examine your lens for signs of a cataract.
Depending on the severity of the condition detected by your eye specialist, you get different options to deal with the condition and improve vision.
Cataract Surgery Necessity
When you fail to see things using prescription glasses, then the only effective treatment is to undergo cataract surgery. Surgery can treat cataracts effectively. When you suffer from enhanced glare from lights or blurry vision due to cataracts, invasive surgery can manage the problem. The surgery is also suggested when cataracts interfere with the treatment of other eye problems. So, your doctor opts for it when you suffer from diabetic retinopathy or age-related macular degeneration. But, before choosing the surgery, you need to analyze your option thoroughly and make the right decision. Waiting for the surgery may not affect your eyesight. Before undergoing surgery, you need to think about the following factors:
Check If Surgery Is Right For You
Talk to your doctor to check if surgery is the right option for you. If you have a good vision, then you may not need surgery for many years. You can use other alternative therapies to manage the slight vision problem. The doctors only suggest the surgical option when cataracts affect your quality of life or make it difficult for you to perform daily tasks like reading or driving after dark.
Detect Other Issues Causing Complications
You need to discuss your options with the doctor. While some people may not have the rush to remove cataract immediately, others may suffer from medical conditions triggering complications to the eye. People suffering from diabetes can experience cataracts worsening. So, you need to talk to your doctor about it.
Analyze Pros And Cons
Since delaying the surgery may not affect your recovery time or how your vision improves, you can make a decision based on the pros and cons of each surgery. You have different surgery options available. It is important to talk to your doctor to decide the right one suiting your purpose. Take time to consider the risks and benefits associated with the surgery. Discuss in detail the different aspects of the surgery like time to recover, resuming your duties, periodic checkups and other details with your doctor based on your specific situation.
Risks Associated With Cataract Surgery
While many think cataract surgery is the easiest option, it is not true. The surgery has certain risk factors associated with it. But, people who suffer from complications are few. It is also possible to treat the complication effectively. So, the risks associated with the issue are:
- Eye infection
- Inflammation
- Bleeding
- Drooping eyelid
- Swelling
- Inflammation
- Retinal detachment
- Glaucoma
- Dislocation of artificial lens
- Secondary cataract
- Loss of vision
People suffering from a serious medical condition or other eye problems face the enhanced risk of developing a complication. In rare cases, the surgery fails to improve vision. It is due to the underlying eye damage due to other conditions. So, people suffering from issues like macular degeneration or glaucoma may not see vision improvement. It is essential to get treatment for other eye problems first before undergoing cataract surgery.
Preparing For Cataract Surgery
Before undergoing the surgery, you need to prepare yourself for the procedure. You have to take care of the following:
Food And Medications
Doctors offer instruction to avoid eating food or drinking anything twelve hours before the surgery. To prevent any complications, you need to temporarily stop taking medications to increase your risk of bleeding (like aspirin) during the procedure. You have to inform your doctor about the medications you take, especially for the prostate problem. It is because the drugs can interfere with the surgery. Your ophthalmologist prescribes antibiotic eye drops for your eyes. You need to use it one or two days before the actual procedure.
Other Precautionary Measures
While you can go home the same day after the surgery, it is better to bring someone with you. It is important as you cannot drive after the surgery. You need to rest. So, arrange a ride home or ask someone to accompany you. You have to take it easy after the surgery for a few days. So, if you work in a physically demanding job, then make arrangements to transfer your workload. Limit your bending and lifting for at least a week after the surgery.
What To Expect With Cataract Surgery?
Before undergoing the surgery, you may have apprehension about it. Your mind may fill with doubts and concerns. So, before undergoing the procedure, talk to your doctor. But, here is the information on what to expect when undergoing the surgery.
Before Cataract Surgery
Before the surgery, your doctor checks the size and shape of the eye. You need to see your doctor undergo a painless ultrasound test to measure eye size. It is essential to determine the right type of lens implant (IOL or intraocular lens) needed to replace your cataract ridden lens. The majority of the people who undergo cataract surgery have IOLs. The replaced lens improves the vision as it focuses light on the back of the eyes. But, you can never see or feel the lens. These lenses require no care like a contact lens. It becomes a part of your eye permanently. You have different varieties of IOL available with specific features. You need to discuss your options with your eye doctor based on your individual needs and eye condition. So, your doctor can suggest the best IOL that works best for you and your lifestyle.
Since most of the insurance companies offer no reimbursement for all the lenses, you need to make a choice based on the cost too. Different types of IOL are available like:
- Plastic
- Silicone
- Acrylic
You also have IOLs that block ultraviolet rays. While some are rigid plastic, implanted using an incision needing several sutures to close, others are flexible. So, such IOLS require only a small incision with few or no stitches. Your eye surgeon removes the natural lens affected by cataract and replaces it with the artificial lens. After folding the artificial lens, the surgeon places it in the empty capsule (in place of natural lens). The IOLs fill the empty capsule inside the eye and improves vision.
Types Of IOL Lens Available
You have different types of lenses available. You need to talk to your eye doctor about the best one that suits your needs. The lens includes:
Fixed-Focus Monofocal
It is the type of lens having a single focus strength. So, it is ideal for distance vision. But, people who use the specific lens need reading glass for reading or seeing at a distance.
Accommodating-Focus Monofocal
While such a lens only has a single focal strength, the lens responds to eye muscle movements. So, they are capable of shifting focus to distant or near objects.
Multifocal
The type of lens is similar to the progressive or bifocal lens used in glasses. The different areas of the lens have diverse focusing strengths. So, it allows you to have near, medium, and far vision.
Astigmatism Correction (Toric)
It is the lens ideal for people who have significant astigmatism. The toric lens can correct vision for people suffering from astigmatism.
Before choosing the lens, you need to discuss the risks as well as the benefits of each type of IOLs with your eye specialist. After discussing the options, you can determine the best one for you.
During Cataract Surgery
Your eye surgeon performs the surgery on an outpatient basis. So, it takes only one to two hours or less to perform the surgery. Before undergoing the procedure, your doctor places eye drops in your eyes. It is to dilate the pupil. You also receive local anesthetics to numb the area. Often, the doctor provides a sedative to patients before the surgery to help them relax. If you take sedatives, you remain awake during the procedure but feel groggy. During the procedure, the surgeon removes your clouded lens. Your surgeon replaces it with a clear artificial lens. In some cases, your doctor removes the cataract and does not implant an artificial lens.
Methods To Remove Cataracts
The surgical methods to remove cataracts include the following:
Phacoemulsification
The procedure uses an ultrasound probe to break the lens in your eyes for removing it. The surgeon makes a tiny incision. The incision made in the cornea (in front of the eye) helps to insert a thin probe. Your doctor inserts the needle-thin probe into the lens affected by cataract. The eye surgeon uses probe transmitting ultrasound waves. It is to emulsify (break up) the cataract in the lens. Fragments are suctioned out while the lens capsule (back of the lens) is left intact. It serves as the place for an artificial lens to rest. Your surgeon uses stitches to close the tiny incision in the cornea at the end of the procedure.
Extracapsular Cataract Extraction
It is the procedure that removes the cataract ridden lens in your eyes in one piece. The eye surgeon makes a large incision for such a procedure. It is the less frequently used procedure compared to that of phacoemulsification. Through the large incision, the surgeon used special surgical tools to first remove the front capsule of the lens. Then, the surgeon removes the cataract-ridden, cloudy lens. But, the back of the lens (lens capsule) is left intact. It acts as the resting place for the artificial lens. It is the procedure suggested when you suffer from specific eye conditions. The large incision needs stitches to complete the process.
After the removal of a cataract affected lens using either of the two procedures, the surgeon implants an artificial lens into your empty lens capsule.
After Cataract Procedure
Once your doctor completes the cataract procedure, you can see improvement in vision within a few days. Your vision may seem blurry at first. It is because your eye starts healing and adjusts to the surroundings. You can observe the following after the procedure:
Changes in Color
While you heal completely, colors seem brighter. It is because you are now seeing things using the new, clear, lens.
Follow-Up Appointment
You need to see the eye doctor one or two days after the surgery and the following week. Then, you can make an appointment a month after the last appointment to monitor healing.
Follow Instructions
You can experience mild discomfort and itching for a few days after the surgery. Try to avoid rubbing your eyes. The discomfort disappears after a few days. While healing follows the steps:
- Wear protective eye patch to shield the eye even at night during the recovery period.
- Use prescription eye drops as well as other medication prescribed by the doctor to reduce infection, inflammation, and control eye pressure.
Use Of Glasses
Some people need glasses after cataract surgery. So, you need to see the eye specialist. The doctor prescribes for glasses once you heal from the surgery.
Contact Doctor
If you experience the following signs after the surgery, then see your doctor immediately as they require immediate medical attention:
- Vision loss
- Eyelid swelling
- Increased eye redness
- Floaters or light flashes in front of eyes
- Persisting pain (even after using OTC pain medications)
People suffering from cataracts in both eyes need to schedule the second surgery after complete healing of the first eye.
Results Of Cataract Surgery
Cataract surgery is successful in restoring vision in a huge number of people. The majority of people who undergo the procedure see good results. But, you can also expect certain side effects like secondary cataract development after the procedure. The complication is common and is also known as PCO (posterior capsule opacification). You suffer from PCO when the part of the lens that was not removed by the surgeon during the surgery (back of the lens) and the portion supporting the new lens implant becomes cloudy. It can cause vision impairment. So, you need to make appointments for frequent checkups to detect the problem.
It is easy to treat PCO as you have to undergo a five-minute procedure. The outpatient procedure, known as YAG (Yttrium Aluminum Garnet) laser capsulotomy clears the clouded capsule by making a small opening. A laser beam is used to create the opening through which the light can pass without difficulty. You have to stay for at least one hour in the doctor’s office to ensure you feel no pressure on the eyes. With regular eye testing, you can keep your vision clear for a long time after the surgery.
Conclusion
Cataract surgery is a short and uneventful procedure with huge success rates. If you have no major health concerns or other eye problems, then you can expect fast recovery. It also has a high chance of a good outcome. After the surgery, you will have a sharper and clearer vision. But, talk to your doctor about the pros and cons of the procedure before making a decision. Follow the instructions suggested by the doctor after the procedure to ensure good results.
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